As different as health providers and payer systems across the world may be, the challenges within them and the visions of their thought leaders are strikingly similar.
In collaboration with McKinsey & Co., the World Economic Forum talked with more than 200 health system leaders and policymakers in China, Germany, The Netherlands, Spain and England to find out what they wanted their health systems to look like in 2040. What resulted was a new, 32-page analysis called Sustainable Health Systems — Visions, Strategies, Critical Uncertainties and Scenarios.
Over the last 50 years, total healthcare expenditure of OECD-member countries has grown faster than gross domestic product, and some predict that it will grow another 50 percent to 100 percent by 2040. Collectively, the countries included in the report unanimously saw the need for more accountability on the part of influencers in government, technology, media, financial services, telecommunications and education to make health and care more sustainable.
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“There is a need to bridge the gaps between supply and demand, population health and individual healthcare, and healthcare and other related industries,” the report’s author wrote.
In discussions of how to do that, three major themes emerged across all five nations. First among them was a universal embrace of data and information, both in care delivery and in improving the efficiency and effectiveness of health systems. Here are a few interesting suggestions from the participants:
- Create a common set of data standards so that costs and outcomes are measured and recorded in the same way.
- Mandate minimum data sets for providers. Payers, then, either pay for data or do not reimburse for care delivered without the required data sets.
- Launch an international data exchange/data clearinghouse to serve as an open source of information for health research.
- Craft legislation so that patients own their health records and their identifiable data can be used only in direct care, unless they give consent for other use.
Secondly, healthcare providers need to innovate delivery. Disease has shifted over the last century: There are fewer deaths from infectious diseases and work injuries, but more from chronic lifestyle diseases. Meanwhile, the structure of the care system has barely changed.
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Countries differed in how they think care should change. Participants in the UK, for example, proposed making the home the main setting of care and interacting virtually with doctors. In China, participants suggested a new profession of proactive wellness counselors.
Thirdly, to slow the demand for healthcare, all countries must build healthy populations. That kind of behavior change will require buy-in from a much larger set of stakeholders including urban planners, the food and drink industries and education systems.
The success of these strategies, however, hinges on six uncertainties:
- How will individuals’ willingness to share health risk across a population change?
- At what level will healthcare be governed?
- Where will innovation come from, and how will it be funded?
- Who will claim “ownership” of health data?
- How will people adopt lifestyle changes that society encourages?
- Will healthy living become a civic duty, an aspiration of a minority choice?
Focus should remain on developing diverse, long-term strategies for reducing the demand for care, the report concludes.
[Photo from World Economic Forum/McKinsey report]
